If you live in a no-fault state, such as Florida, you may wonder who is to blame for your car accident. Without fault, who can you collect compensation from? Where can you turn for help and who will pay for the damages done to you and your property?
When you live in a no-fault state, you also need to find answers to questions about the very meaning of no-fault and how that will affect your claim:
- What does “no-fault” auto insurance mean?
- What does a “no-fault state” mean?
- What happens if you suffer injuries in a car accident in a no-fault state?
The term “no-fault insurance” confuses many people. It doesn’t mean that there is never any liability for a car accident. It also doesn’t mean that you can’t contact a lawyer and receive compensation for your injuries.
What Is No-Fault State Car Insurance?
In the U.S., each state is allowed to decide what type of auto insurance laws they will require. Some states choose to be a tort liability state, while others choose to be a no-fault state. No-fault state car insurance, also known as a personal injury protection (PIP) policy, is required in many states.
It is designed as a way to provide compensation quickly for car accident victims through their own insurance and is there regardless of fault in the accident. Its primary goal is to reduce the number of personal injury lawsuits filed by car accident victims. PIP policies generally cover a portion of the costs of the following damages:
- Medical costs: In Florida, PIP policies will cover up to 80% of medical costs for emergency medical conditions up to the limit of the policy, provided the treatment is received by a licensed physician, dentist, hospital, or facility that is owned by the hospital. For less serious injuries, the policy will provide up to $2,500.
- Lost wages: PIP policies cover a portion of the wages that an injured accident victim lost due to being too injured to work or work missed for doctor’s appointments or medical procedures related to the injury. In Florida, PIP policies are required to cover up to 60 percent of lost wages, based on the individual’s income for 13 weeks immediately preceding the accident.
- Death benefits: this includes funeral and burial expenses. Florida’s PIP policies provide up to $5,000 in death benefits to qualified survivors.
While these items are usually covered through an individual’s PIP policy, a number of common damages from car accidents are not. Those items not covered by no-fault car insurance policies include:
- Damage to your car and other property or the other driver’s car or property
- The bodily injuries of the other car’s occupants
- The bodily injuries of adult passengers in your vehicle or adult friends who have borrowed your car provided they have their own PIP coverage and are not named on your policy.
- Pain and suffering claims
When you get into a car accident and you live in a no-fault state, you must submit a PIP claim. Your insurer then has 30 days to either accept the claim and pay the expenses or deny the claim. If your insurer denies your claim, they must provide you with a written explanation as to why. This gives you an opportunity to appeal the denial.
A qualified car accident attorney can assist you with that appeal. Certain vehicles are excluded from the requirement of no-fault coverage, including motorcycles, specialty vehicles designed for off-road use, and commercial or business vehicles. However, if you’re injured in an accident while riding your motorcycle, or even as a pedestrian or a bicyclist, the PIP policy that you purchased for your car may cover your injuries.
Which States Require No-Fault Car Insurance?
There are many no-fault states across the country. Florida is a no-fault state. Even though legislators have tried to repeal these laws in the past, they have not succeeded.
There are many no-fault states across the country. In addition to Florida, the following jurisdictions have no-fault insurance systems:
- District of Columbia
- New Jersey
- New York
- North Dakota
- Puerto Rico
The rules regarding no-fault insurance and making a claim vary among the above locations. In fact, some states allow residents to opt out of the no-fault system when they purchase their car insurance policy. Florida’s no fault insurance laws, however, mandate that you carry a no-fault state car insurance policy with a minimum limit of $10,000 upon registering your vehicle. You are also required to purchase property damage liability insurance that will cover the costs of damage to the other driver’s vehicle if you cause an accident.
The Benefits and Disadvantages of No-Fault Car Insurance
Proponents of no-fault insurance like that it allows Florida drivers to deal with their own insurance company when they are injured in a car accident. The traditional method of determining blame forces accident victims to prove their injuries to another driver’s insurance company. This often results in filing a car accident lawsuit to collect compensation.
With PIP, no blame has to be assessed before coverage begins. This means that medical expenses and lost wages are paid out under the policy in a more timely fashion. However, there are some cons to no-fault state car accident insurance, as well.
Cons of No-Fault Car Insurance
One of the cons of this type of insurance is that the claim on the driver’s insurance—even if they were not at fault for the accident—may result in an increase in premiums. In 2013, new laws determine how much compensation a person can obtain for their PIP claim. This has resulted in a lower payout for those whose medical conditions are not emergent.
Additionally, unless a person’s injuries are permanent, they cannot file a personal injury lawsuit against the at-fault driver and access funds for general damages such as pain and suffering.
In no-fault states, auto insurance companies pay for a larger number of medical services and they pay more for medical services than they do in states without a no-fault system. This may result in higher insurance premiums for drivers in no-fault states as a whole. No-fault states tend to see a higher number of fraudulent claims, as well. The reforms to Florida’s no-fault insurance law that were passed in 2012 and implemented in 2013 reportedly caused a significant reduction in the number of fraudulent PIP claims that the state receives.
What Happens When You Get into a No-Fault Car Accident in Florida?
You might hear people talk about a no-fault car accident. This does not mean that no one is at fault. In states that have no-fault laws, some people use this term to describe a car accident that occurs in a no-fault state.
Every car accident has a cause and determining who is liable for your accident is one of the ways you can collect the most compensation for your injuries and damages.
When You Are at Fault for a Car Accident
If you cause a car accident and you suffer an injury, you can generally file a claim under your PIP policy with your insurance company. If you drove while impaired at the time of the accident or you intentionally caused the accident, your insurance company may not allow you to file a claim. In Florida, you must seek medical treatment within fourteen days in order to be eligible for compensation through your PIP policy.
If the other driver or the occupants of the other car also suffer an injury, their own PIP policy will cover their injuries, up to the limits of the policy. However, if their expenses exceed the limits of their policy, they may make a third-party claim against your insurance. If the injuries are serious or permanent, they may file a personal injury lawsuit against you.
In addition to a no-fault car accident insurance system, Florida also has a system of pure comparative negligence that applies to personal injury lawsuits. What this means is that even if the other driver had some blame for the accident, they can still seek compensation from you in the event of serious and permanent injuries. However, any award they receive will be reduced by the percentage of blame that is theirs.
When Another Driver Is At Fault
If you suffer an injury in a car accident caused by the negligence of another person, you should seek medical care immediately. Not only is this just good sense, but also Florida’s no-fault law requires that you seek initial medical treatment within 14 days of your accident to receive PIP benefits. Not seeking treatment could deprive you of PIP benefits and make it harder for you to recover benefits from any additional insurance you carry.
You still want to file a claim under your PIP policy, even if your injuries are serious or permanent. This will give you access to compensation for your initial treatment. You will likely spend the $10,000 policy quickly on your initial emergency room visit.
As such, you will need to speak to a no-fault car accident attorney about your legal options. This includes filing a third-party claim if the driver had bodily injury liability coverage or filing a personal injury lawsuit.
Why Did My Insurance Company Deny My PIP Claim?
You pay the premiums for your insurance policy and now you’re injured and have made a claim under your PIP policy. Is there any reason to worry that your insurance company will deny your car accident claim? Unfortunately, yes.
Insurance companies deny no-fault PIP car accident claims for a number of reasons, including:
- The medical treatment that you received was not reasonable or necessary
- A licensed physician, dentist, hospital, or a facility owned by the hospital did not approve the medical treatment
- The deadline has passed for you to make a claim
- You did not seek medical treatment within the 14-day window for PIP coverage eligibility
- Your injuries were not an emergency medical condition and therefore don’t qualify for compensation up to your policy limit
- The injuries were due to a pre-existing condition
- The injuries were not caused by the car accident
- You intentionally caused the accident
- The car accident occurred while you were committing a felony
- You were driving someone else’s car without their permission when the accident took place
- Your insurance has lapsed
- The damages you are asking for are not covered in your policy
There are many reasons why insurance companies deny no-fault car accident claims. Even when they must pay them, adjusters look for any reason to withhold the payment. They can even attempt to reduce payments without just cause.
Sadly, many injured car accident victims call us simply because they are having trouble dealing with their own insurance companies. We work quickly from the start to help you deal with your insurance company and your PIP claim. We then review your case to help you explore all legal options available to you.
Can I Still File a Personal Injury Lawsuit Against a Negligent Driver in a No-Fault State?
No-fault states, like Florida, allow accident victims who suffer serious and permanent injuries, and whose damages exceed the limits of their PIP coverage, to seek compensation through a personal injury lawsuit. Permanent injuries, as defined by law, include:
- Significant and permanent loss of an important bodily function
- Permanent injury within a reasonable degree of medical probability
- Significant scarring or disfigurement
- Wrongful death
If you sustained an injury that meets the Florida state law’s permanent injury threshold, then you may seek the recovery of damages for:
- Medical expenses beyond your PIP policy’s limits, and future medical care
- Lost wages and loss of future earning capacity
- The cost of household services that you are no longer able to do as a result of your injuries
- Property that was damaged in the accident
- Permanent disfigurement or disability
- Pain and suffering
- Loss of consortium
- Emotional distress
Pursuing Compensation with a Lawyer’s Help
If you pursue compensation via a personal injury lawsuit, your Florida no-fault state car accident attorney will look to see if any of the following situations apply:
- Was there more than one liable party? In Florida, if a person, business, or entity can be subject to liability if at least 10% responsible for causing the accident that led to your serious or permanent injury. An example of a case where there is more than one liable party is if your accident was caused by a negligent driver who is driving a company truck – in this case, both the driver and the company that the driver works for may be found liable for your injuries.
- Will you file your lawsuit in time to meet the state’s statute of limitations? In Florida, the time limit for filing a personal injury lawsuit is four years from the date of the injury.
- What were your damages and how much should you ask for? Your attorney will help you determine an amount of compensation to ask for based on the costs of your economic damages, such as medical bills and lost wages as well as your general damages, which include impacts to your quality of life such as pain and suffering or emotional distress. Your attorney will also evaluate the facts of your case to determine if there is a reason to add punitive damages to your claim, which are designed to punish defendants whose behavior was particularly reckless or negligent.
Do I Need a Florida Car Accident Attorney to File a Claim on My No-Fault Insurance?
You do not need an attorney to file a claim with your no-fault insurance carrier. However, it is always helpful to have an attorney provide guidance and answer any questions you may have during the insurance claim process. Additionally, if your PIP provider denies your coverage or your costs exceed the limits of your policy, then you may want to examine your case with a car accident attorney to determine your best legal course of action.
Contact Our Florida No-Fault Car Accident Lawyers Today
In the event you are involved in an accident that causes severe and permanent injuries then you will likely benefit from hiring an experienced car accident lawyer to assist you. An experienced car accident lawyer can provide you with the skills and resources necessary to not only secure compensation for you but maximize the amount of money you may receive to pay for damages like medical bills, lost wages, loss of earning capacity, as well as pain and suffering. Sibley Dolman Gipe has years of experience helping those that have been severely injured in car accidents.
Our accident attorneys can provide you with award-winning legal insight, settlement negotiating skills, and legal representation in court all while maintaining close communication with the client to ensure that you are kept informed regarding your case’s success. Let us help put you on the path to obtaining compensation for your injuries. With offices across both Florida coasts, you can easily reach Sibley Dolman Gipe Accident Injury Lawyers, PA, and Sibley Dolman Gipe Accident Injury Lawyers, PA, at 833-552-7274 (833-55-CRASH), or contact us online.
Sibley Dolman Gipe Accident Injury Lawyers, PA
800 North Belcher Road
Clearwater, FL 33765